gms | German Medical Science

Introduction: Molecular tumor boards (MTBs) are intended to provide personalized therapy approaches based upon genetic traits for tumor patients who were resistant to all standard treatment approaches. To that end, somatic and germline mutations and their impact on the tumor pathophysiology are investigated and evaluated. During the MTB, a team of multi-disciplinary experts discusses treatment options as well as the participation in clinical trials individually for each patient [1], [2], [3]. The whole process to obtain a treatment recommendation based on the MTB is currently inconvenient and time-consuming for both physicians and documentalists as most of the workflow is not yet digitalized. This substantially limits the number of patients who can benefit from this personalized treatment approach. In this work, a software called MONOCLE (Molecular ONcology Optimized CLinical Evaluation) is introduced to improve and facilitate the workflow of MTBs and to enable high-quality treatment for a larger number of patients.

State of the art: A dedicated collection of previous MTB data streams and a subsequent improvement concept was presented by Lauk et al. [4] using a Business Process Modeling and Notation (BPMN) software. They showed recommended steps leading to improved adaptability and interoperability, as well as increased levels of standardization and quality assurance in the field of personalized therapy recommendation and treatment.

Concept: The proposed concept by Lauk et al. [4] is implemented and adapted to fit technical and administrative requirements within a German university medical center. The software MONOCLE is introduced into the daily clinical routine of MTB physicians and documentalists.

Implementation: The log-in via an administration protocol, in which detailed rights of usage and usage rights are assigned, protects the patients' data from being viewed by unauthorized persons. The medical and clinical records of the MTB patients are generated during the admission process. Subsequently, during each step of the MTB, any information concerning the patient can be documented and tracked within the tool. The clinical and genetic core data set is recorded according to the specifications of the German Network for Personalized Medicine (DNPM). The MTB report and the therapy recommendation can be adopted to the organizational requirements. Further information concerning the patient can be noted in the patient file via comment functions. Ensuring proper interoperability, it is possible to export the core data set, the MTB report, and the therapy recommendation from the software. The software was programmed by developers at the University Hospital and installed in the hospitals protected scientific information system.

Lessons learned: The workflow of the MTB is substantially facilitated by the introduction of MONOCLE into the clinical routine of the UKE as it enables standardized and uniform documentation. This leads to an improved and faster collaboration among the professions involved in the MTB and results in an increased number of patients benefiting from the MTB. The application of the MONOCLE tool is not limited to the MTB at UKE as the documentation was done according to the DNPM specifications. The tool can thus be easily transferred to other university hospitals within the DNPM network.

Author contributions: The authors Gundler C and Riemann LT contributed equally.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.